Introduction
Pressure ulcers, commonly known as pressure sores or bedsores, refer to injuries that affect the patient’s skin and the tissues, basically caused by continued pressure on someone’s skin. Pressure ulcers can usually happen to anyone, but they frequently affect people who are limited to bed or those in a wheelchair for a long duration. As per Gefen (2021), the growth of pressure ulcers is a serious issue that can lead to interruption in someone’s recovery since it might be complicated by infection for a long while. Gefen (2021) argues that healthcare staff should make sure that the patient’s comfort is maintained by relieving the pressure and avoiding the subjection of skin to shear forces. This paper presents a literature review on healthcare staff education on pressure ulcer prevention. The project is geared toward geriatrics, bedbound among other patients at a skilled nursing facility or rehab.
Methods of Searching
This literature review was conducted using electronic resources, specifically the peer-reviewed works found on Google Scholar, among other reliable channels. The sources used in this review are published journals with digital object identification. Furthermore, online books and websites that have a notation to major healthcare bodies such as American Nursing Association (ANA) among others have been used. There is a total of eleven sources that have been utilized to bring relevant content about the management of pressure ulcers to the targeted group. Thus, the content presented in the paper derives significance from the resources used.
Review of the Literature
Healthcare staff should be educated on stopping and managing pressure sores in the specified group of patients. If they hold the knowledge, it could be one way of helping to take care of the patients living with such conditions and managing pressure ulcers. Beal and Smith (2016), evaluate the importance of keeping nurses and doctors trained on how to prevent pressure sores. According to the authors, the effect of educating healthcare professionals on pressure ulcer prevention may lead to better patient care for people living with such conditions, particularly bedbound individuals (Beal & Smith, 2016). Beal and Smith present evidence that healthcare staff trained to handle pressure ulcers may perform better than those without such knowledge.
Nutritional elements such as choice of diet help in preventing the growth of pressure sores. According to Burch and Kopke (2017), poor nutritional status may lead to little tolerance of skin and fundamental body tissues when it comes to pressure. Thus, the resistance and shearing force enables high chances of bedsores for individuals aged 65 and above. Burch and Kopke’s study shows that if a mixed nutritional supplement is given to geriatric patients in hospitals or other care facilities, there is a notable change in bedsores growth. Thus, nutrition is important when an individual needs to manage bedsores.
Care facility personnel require knowledge of the essence of dietary elements in stopping pressure ulcers. According to Penman et al. (2020), dietary intake contributes significantly to the management of bedsores for people with limited mobility or older individuals. The reason is that body requires proteins, vitamins, and minerals such as iron and zinc to support the healing process. For example, care staff can guide the patients to have dietary intakes supplemented by nutritious snacks between meals as one way to prevent or treat pressure ulcers. Therefore, training hospital staff in the knowledge of pressure ulcer prevention is vital.
To prevent bedsores, an assessment of the impact of dressings and topical agents in geriatrics who have not had a history of ulcers is considered. Staff working in healthcare facilities must be trained on how topical agents contribute to preventing pressure sores so that they may advise patients with limited mobility, such as individuals in wheelchairs. According to Burch and McCallum (2016), topical agents such as fatty acids and olive oils may determine pressure ulcers in patients. About 96% of patients subjected to topical agent intervention measures would show positive results (Burch & McCallum, 2016). Trials reports show that ulcer incidents were lower with fatty acid-containing treatment compared with control compounds of tristearin.
By reviewing some sources, the project finds that standard traditional means help prevent pressure ulcers. For instance, the silicone procedure is more efficient in lowering the growth of bedsores. According to Burch and Tort (2016), there is efficacy and value in combatting pressure sores by the utilization of silicone foam coverings. Silicone foam dressings such as Mepilex that have silver act as antibiotic agents leading to less skin abrasion hence, stabilizing the skin for individuals who may have pressure-related conditions (Burch & Tort, 2019). Care facilities ought to train nurses and doctors on how to apply such agents as one way to regulate and manage this medical condition in the older group and any other specific target.
There are many ways of preventing pressure ulcers for geriatrics and mobility-restricted patients. Citing literature by Kalyani & Mohanasundari (2016), patient safety involves preventing pressure ulcers, a subject that doctors and nurses must know. The study shows that regularly changing positions for limited mobility patients is important. The reason is that it allows the circulation of blood to be efficient in the body (Kalyani & Mohanasundari, 2016). Additionally, a patient should check the skin every day to ascertain cases where pressure ulcers may be evident in the body.
In cases where geriatric patients or bedbound persons have been diagnosed with pressure ulcers, the staff working in care facilities are advised to know a raft of actions to treat such conditions. Citing to Townsend (2018), adults have been mostly affected by this healthcare issue. The author argues that applying dressings to speed the recovery is important. The use of specially designed mattresses to pump the flow of air to patients is considerable in this case (Townsend, 2018). Additionally, cleaning wounds and removing damaged tissues would be important to help from the deterioration of the situation.
Implementing quality improvement education to healthcare facility staff using evidence-based practices (EBP) is important to increase the knowledge on how to prevent pressure ulcers. According to Sayin (2019), most preventive interventions support the idea that pressure ulcers can be prevented. For instance, advanced static mattresses and overlays are linked to a lower risk for pressure ulcers when compared to normal mattresses. Other pieces of evidence that need to be informed to the staff include nutritional supplementation, cleanser, dressings, and lotions (Sayin, 2019). When healthcare staff has such skills, they will advise and guide patients, marking an epitome of a long journey to preventing pressure ulcers in society.
Knowledge on how to deal with bedsores can be retained by care staff when quality improvement education plans are practiced. The reason is that when nurses are aware of the solution to the condition, they lead to the patient’s knowledge and participation in preventing pressure ulcers. Schoeps et al. (2016) insinuate that the combined efforts between the healthcare staff and patients lead to the successful management of pressure ulcers. 45% of patients who are given such information will willingly assist in following the laid metrics about controlling the condition. Thus, keeping healthcare staff aware of prevention techniques is important to fight pressure ulcers.
Training staff in hospitals and skilled care facilities leads to relevance in getting prevention measures on pressure ulcers done efficiently. According to Zdzioch (2017), there is a raft of guidelines on preventing pressure ulcers. That means healthcare facility staff can obtain knowledge about that from this article. For example, Zdzioch argues that patients that have a high possibility of developing bedsores, such as the older groups need repositioning frequently at least four times daily. The repositioning techniques include a 30° slanted side-lying position, which should be done alternatively on all sides. Thus, if clinical workers get all these tips, it could be easier to prevent pressure ulcers.
Findings
The project has reviewed scholarly sources about how to deal with bedsores for geriatrics and limited mobility individuals. From the sources used in previous sections of the paper, the literature helps one understand that common interventions can be useful to combat bedsores. First, nutrition has been mentioned regularly, and thus, diet would be a key aspect to consider while treating or fighting the growth of pressure ulcers (Townsend, 2018). 10% of persons hospitalized have this medical issue, while 40% of the number have malnutrition issues that lead to bedsores (Schoeps et al., 2016). The role of diet is clear as macro and micronutrients are needed by each organ to enable the proper functioning of all body parts.
The other notable idea on how to fight pressure ulcers is foam dressing with specific agents. From the literature review, this project concurs that hydrocolloid, silicone, and film foams are useful in managing this condition in geriatrics and those with challenges of freely moving with their feet (Zdzioch, 2017). Furthermore, some therapeutic interventions would be key in preventing these conditions, such as static foam mattresses and cushions that help pump the constant flow of fresh air. In most serious cases, surgery is undertaken to remove the damaged tissues and closing of the wound is done to prevent further deterioration of the body tissues (Burch & McCallum, 2016). More than 38% of patients with body challenges have experienced this health problem; thus, prevention is important to ensure the comfort of the patients (Penman et al., 2020). For patients with movement challenges, such as those with wheelchairs, it is important to keep on changing their position to help in blood circulation.
Conclusion
In preventing pressure ulcers, there is a need for a collaborative base between the hospital administration, the staff, and patients. For instance, training staff to handle pressure ulcer’s related cases will give the personnel experience in advising patients about issues such as choice of diet, lifestyle, and general monitoring of the skin. Additionally, it is significant to have dressing foams using various agents such as silicone for the specified groups. Dressing foam enables regular binding of the body tissues, hence strengthening the patient’s body, which is a key milestone towards preventing pressure ulcers (Burch & Tort, 2019). Lastly, it is important to have therapeutic interventions such as training the patients to change their positions, more so the bedbound individuals. For geriatrics, having advanced static comfortable lying zones will help pump the air in the body hence preventing the risk of pressure ulcers. Educating doctors and nurses on controlling the possible development of this condition reduces chances in older people and bedbound patients.
References
Beal, M., & Smith, K. (2016). Inpatient pressure ulcer prevalence in an acute care hospital using evidence-based practice. Worldviews On Evidence-Based Nursing, 13(2), 112-117.
Burch, J., & Köpke, S. (2017). Do nutritional interventions help prevent the development of pressure ulcers? Cochrane Clinical Answers, 5(4), 34-37.
Burch, J., & McCallum, I. (2016). What are the effects of topical agents used to prevent pressure ulcers? Cochrane Clinical Answers, 6(7), 90-94.
Burch, J., & Tort, S. (2019). Can silicone dressings help prevent pressure ulcers? Cochrane Clinical Answers, 2(5), 31.
Gefen, A. (2021). The etiology of medical device-related pressure ulcers and how to prevent them. British Journal of Nursing, 30(15), S24-S30.
Kalyani, V., & Mohanasundari, S. (2016). A patient safety: Preventing pressure ulcers. Indian Journal of Surgical Nursing, 5(3), 97-105.
Penman, A., Crowder, K., Hochman, M., & Watkins, W. (2020). 50 studies every ophthalmologist should know. Oxford University Press USA – OSO.
Sayin, A. (2019). Evidence-based practices for the prevention of pressure ulcers. Journal Of Health Services and Education, 3(1), 7-10.
Schoeps, L., Tallberg, A., & Gunningberg, L. (2016). Patients’ knowledge of and participation in preventing pressure ulcers- an intervention study. International Wound Journal, 14(2), 344-348.
Townsend, K. (2018). Fundamental concepts and skills for the patient care technician. Elsevier Health Sciences Publishers.
Zdzioch, M. (2017). Pressure ulcer prevention. Nursing Standard, 31(21), 64-65.